Kawakami Mamoru, Tamaki Tetsuya, Ando Muneharu, Yamada Hiroshi, Matsumoto Takuji, Yoshida Munehito
Department of Orthopaedic Surgery, Wakayama Medical University, Kimiidera, Wakayama City, Wakayama, Japan.
J Spinal Disord Tech. 2002 Aug;15(4):277-83. doi: 10.1097/00024720-200208000-00003.
Sixty-seven patients with cervical spondylotic myelopathy treated with expansive laminoplasty were retrospectively reviewed at a minimum 2-year follow-up. This study was designed to evaluate whether preoperative instability influences the clinical outcome in patients with cervical spondylotic myelopathy treated with laminoplasty without spinal fusion. Patients with preoperative instability were older and had shorter durations of symptoms prior to surgery than those without the instability. There were no significant differences in prevalence of axial symptoms, neurologic recovery, or radiologic findings between patients with and without preoperative cervical instability. At follow-up, the cervical range of motion was limited to 43.5% of the preoperative range, and no cervical instability was observed in any patients. Preoperative instability does not influence the clinical outcome and can be ignored if expansive laminoplasty is indicated for patients with cervical spondylotic myelopathy.
对67例行扩大椎板成形术治疗的脊髓型颈椎病患者进行了回顾性研究,随访时间至少为2年。本研究旨在评估术前不稳定是否会影响行非融合椎板成形术治疗的脊髓型颈椎病患者的临床疗效。术前存在不稳定的患者比无不稳定的患者年龄更大,术前症状持续时间更短。术前存在颈椎不稳定和不存在颈椎不稳定的患者在轴性症状发生率、神经功能恢复或影像学表现方面无显著差异。随访时,颈椎活动范围限制在术前范围的43.5%,所有患者均未观察到颈椎不稳定。对于脊髓型颈椎病患者,如果需要行扩大椎板成形术,术前不稳定不影响临床疗效,可不予考虑。